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Sir Geoffrey Johnson Smith: Meals on wheels.
Sir Peter Emery: Meals on wheels, which is a very important service. We move from meals on wheels to health.
Sir Geoffrey Johnson Smith: I introduced that Bill at the behest of the Women's Royal Voluntary Service. I should like to thank my right hon. Friend for playing some part in this Bill. During my absence on official business, he gallantly stood in for me on First Reading: I am most grateful to him for presenting the Bill to the House.
Sir Peter Emery: That is very kind of my right hon. Friend. I think that gallantry is a slight overstatement, but I am delighted to accept it.
I shall be brief, because much of what needs to be said has already been said. I am also interested in the next Bill, the Food Labelling Bill, which would have a great effect
on my constituents, and on the farming industry in particular. I want to ensure that that Bill gets a Second Reading this time.
It is obvious that it is nonsensical that someone can escape from investigation by leaving the service and saying, "That's it. Whatever mistakes I may have made, you can't go any further in investigating what I did, because I am no longer part of the service." That cannot be right, but it obviously was not considered during the passage of the original legislation. The Bill is designed simply to ensure that, when the action of any person working in the NHS needs to be investigated, that person will not be able to escape by resigning.
Such a requirement is desirable for two reasons. First, it would assure patients--our constituents--that genuine complaints will be investigated, and that no one will be able to thwart the process by leaving the health service. Secondly, it would enable those working in the service to state that any errors or complaints will be investigated fully and properly, irrespective of whether they are still so employed. The Bill proposes to insert after "if they are"--employed in the service, that is--the words
Having had to deal with private Members' Bills when I was a Minister, I can tell the present Minister that civil servants are inclined to say, "This Bill deals with a minor issue. Many other matters need tidying up. Why not say to the Bill's promoter, 'We like your idea, but perhaps you will give way and allow us to introduce legislation that covers the wider issue more comprehensively'?" Those of us who have been in the House for a long time will have heard that sort of thing from Ministers of all persuasions, and I fear that the present Government may take the same line now, although I hope that they will not.
Of course the law could be strengthened in other respects. It is obvious, for instance, that some change is needed to the General Medical Council, and greater powers of investigation may also be necessary. A number of matters that are not in the Bill, however, might be covered under its general aegis. We accept that other aspects of the health service may need to be reformed, and we would support the Government in such action, but I plead with the Minister not to ask my right hon. Friend to withdraw his Bill and wait for the Government to act.
The Minister is fairly new in her post, but I am sure she knows that getting a private Member's Bill into the Government's programme is terribly difficult, and the more minor the Bill, the more difficult it is. If the Government took the line that I have described, even the little alteration proposed by this Bill might not be made for four, five or six years. I am sure that the Minister will be able to elaborate on other matters that need to be dealt with, but I implore her to allow my right hon. Friend and the Bill's sponsors their little but, I think, important amendment to the original Act. It is simple and definite, and could, we suggest, be implemented three months after the enactment of the Bill.
Mrs. Janet Dean (Burton):
I support the Bill, but I wish that it went a little further, especially in dealing with potential problems in the private sector. It does nothing to prevent someone working in that sector from engaging in malpractice which an ombudsman would not be able to investigate.
I have another concern, which may be answered later. How long after the retirement of a doctor could an action be brought? The arrangement in the Bill seems to be open-ended. While I accept that it is vital for patients to be protected, and to feel that they are protected, I think it equally important to prevent circumstances in which a doctor, many years after his or her retirement, could be brought before an ombudsman because of an action that took place a long time ago. That loophole must be closed.
The Consumers Association has raised several issues in that context. It points out, for instance, that important information about a practitioner's performance may never come to light. That should be dealt with, especially in the light of recent events. A doctor may retire from general practice, but then work as a locum or move to the private sector, and an ombudsman will not be able to investigate. It is vital that information is available to enable a complaint to be dealt with right through to the end.
Mr. Philip Hammond (Runnymede and Weybridge):
The hon. Lady mentioned the private sector. I wonder whether she was as disappointed as I was by the Government's failure to take the opportunity in the Care Standards Bill to ensure proper regulation of clinical standards in that sector. Can I take it from the tone of her remarks that she would support amendments to that Bill to bring about such regulation?
Mrs. Dean:
I am sure the Government will consider that. No doubt the Minister will respond to the hon. Gentleman's suggestion later.
People must feel that they have the right to take their complaints as far as is necessary. I hope that most people, whether or not their complaints are genuine, will approach their own doctors or dentists, so that the problem can be investigated in the surgery, as close as possible to its source. We all know of cases in which medical problems have not been diagnosed as early as they should have been. In such cases, people want to know that a lesson has been learned. Although we seem to be following America with litigation, most people do not want to take such action; they simply want to be reassured that when a mistake has been made--when, for example, a medical condition has not been identified, and the patient has been put at risk--the fact has been recognised and steps have been taken to ensure that the same thing does not happen to someone else. It is the same when, tragically, someone has lost a loved one. That person wants to feel that that is unlikely to happen again--that someone has learned a lesson.
People search for answers and for reasons, especially if they have lost a loved one. Most of the time, the questions cannot be answered, but people need to be able to talk. That is probably the most important thing that doctors, dentists and others can recognise. Although loss of life is less predominant in the dental profession it does occur. People need to know that they can discuss these things and to feel that the matter has been resolved. Following
on from that, it is vital that people have confidence in the whole procedure. If the case goes ultimately to the health service commissioner, they will need to be sure that he will address the matter.
As the right hon. Member for Wealden (Sir G. Johnson Smith) has said, it may happen in only a few cases, but it is appalling to think that someone can reach the stage of submitting a complaint to the commissioner, only to be told that the person concerned has retired. After retiring, that person may still operate as a locum. People would be afraid if they thought that someone who had been brought to the attention of the commissioner was treating them as a locum.
As I say, people should have confidence in the system. They should be able to feel that, once a case reaches the commissioner, the matter will be fully investigated. I can think of nothing worse than getting to that point and then finding that the doctor has retired. They must for ever feel frustrated. We all know of constituents who come to our surgeries who experienced some tragedy 10 or 20 years ago--not necessarily medical--and who still live with it. Unless they can get to the bottom of their difficulty, they are never able to put it to one side. I go back to the point: if the matter can be resolved as close to the problem as possible, that will be far better because people are then much more likely to get over it.
Throughout the medical profession, there would be less litigation if answers could be given sooner. I know that it is a vicious circle. People are afraid of being taken through the legal system and, therefore, of answering certain questions, but I wish that we could find a way around that so that people would feel that they could respond to a patient's anxieties and concerns and answer them properly. There would then be less litigation in the first place.
or were at the time of the action complained of.
That simple change is proposed in paragraphs (a) and (b) of clause 1(2).
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